Rants and Musings of a Retail Pharmacist

I had an interesting conversation with an executive at work the other day. And the words that came out of her mouth were quite telling.

It happened a couple of weeks ago. The flu shot administration frenzy was just starting to hit us full steam.

The store I was working at that day received a surprise visit. A vice president within one of my company’s many divisions stopped by during one of her visits to our area.

I was working with another pharmacist at the time and the two of us chatted with this VIP about the flu hitting our area early this year and how we were busy with flu shots.

After I made a comment about local emergency departments already seeing cases of the flu, She said what I feared upper management thought all along. She told the three of us working that day “I hate to say it, but the flu is good for business!”

I stopped what I was working on at the time and glanced back at the other pharmacist on duty. The glance he gave me back must have been the same glare I reciprocated to him.

We didn’t say a word, and soon after this executive was off to do whatever else those people do with their day. But when she was gone, the other pharmacist complained to me about her sentiment.

It does seem cold and callous to view the seasonal flu outbreaks as a business opportunity. In her defense, I’m sure she didn’t mean what she said the way it came across to those of us that heard the comment. At least I hope not.

But the reality is that community pharmacy is now dominated by a handful of large players. They tend to look more at spread sheets and numbers and forget the fact that people are sick and we are not merely numbers on a report but actual people.

I’m not going to celebrate an illness that claims thousands of lives every year even if it brings big business to my employer and my profession. I recognize that getting the flu is a miserable experience. And it could even kill you.

Most of the time the official words that come from large community pharmacy chain executives regarding the flu reference serving the community or supplying a needed vaccination service. Their messages are as prepared as your average politician’s public statements.

But on that day, one executive let slip how I suspect many retail pharmacy executives really feel about the flu. The reality is that the flu spells big business for community pharmacies. And that business translates into big profits.

What bothers me the most about what this executive said was the company I was with at the time. I was working with a pharmacist who was relatively new to my employer. I can’t imagine what his thoughts were regarding his new employer after hearing comments like that from one of our divisional vice presidents.

This really demonstrates the battle community pharmacists have with their employers about perspective. Pharmacists are trained to think clinically, and our focus is more patient care oriented.

Large corporations are more business oriented. They are more concerned with the Xs and Os of profits, inventories, and balance sheets.

And while it’s true pharmacists can’t simply ignore the business side of retail pharmacy, isn’t it also true that the chains can’t disregard the human aspect of our business? This battle to balance opposing reference points plays out day after day in pharmacies eveywhere.

I hope that particular vice president can look past the dollars and realize that the flu is a serious public health threat. And I hope pharmacists can balance their patient focused backgrounds with the need to keep a business running efficiently enough to keep its doors opened and everyone’s job secure.

Sometimes the truth hurts though. Even if it slips out unintentionally in the form of a passing comment.

4 Comments to “The Truth Slips Out”

Unfortunate, but something that may well end up being “solved” by (ironically) focusing more on the money. As healthcare reform/ers and insurers continue to push the cost issue, more focus is shifting to outcomes-based payments. This includes more coverage for prevention (as opposed to treatment), withheld payments for some readmissions, etc.- I think this is a trend that will continue including in pharmacy and will hopefully help negate any perverse incentives like this. In the case of the flu, we already see it with the growing coverage for flu shots.

Giving flu shots can be a double edge profit sword.. the more people that you vaccinate with the flu vaccine the more likely they won’t get the flu or if they do.. will be less severe.. which means that the healthcare system will spend less money on a particular pt and employers and the employee’s productivity may not fall off.
I recently was at a presentation by a Prof at the U of TN and a expert on vaccines and while it was anticipated that giving RPH’s the right to vaccinate.. would increase the number of the population that is vaccinated against several medical issues… but.. the numbers would suggest that RPH’s have just shifted vaccinations from the physician’s office to the pharmacy. Is it better to promote flu vaccines and cause less Rx business later.. or not promote flu vaccines and hope that there is more Rx business later ?

Your VIP person has a distorted view of the “value” of flu shots. Of course, pharmacists (who like to think of themselves a healthcare providers), see immunizing as increasing herd immunity and contributing to the health and welfare of the public as a whole. (See the latest reports on benefits of flu shots). Your company sees immunizing a a big money maker. You can check the CDC website and see the actual cost per dose. Compare that to what you charge a cash pt: 20,25,30 bucks? . Many 3rd parties now pay for flu shots, They will also add on a payment for the administration fee. Medicare B is the most generous with this. You make a much higher profit than with any other prescription. In addition, the pt usually has to walk through the entire store to get to the pharmacy, may shop while waiting his/her turn, then gets a “shopping pass” to use in the future. To say that more folks getting the flu is good for business is just plain nuts.

What corporate pharmacy has forgotten is that its employees are there to provide health care and that is is impossible to do that in a responsible way while worrying about how rxs are in the red. Can someone explain to me how that is good for the patient?

Even though the big chain pharmacies benefit from a busy flu season, I think it is good that the stores educate patients and increase awareness of the dangers of influenza. It is cheaper to prevent the flu than it is to treat it (and also much more comfortable for the patient unless they really hate needles).